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Psychosocial, neuropsychological and neurological status in a sample of heart transplant recipients

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Abstract

The sample for this psychosocial follow-up study was formed using the 71 surviving patients from a total of 100 who underwent heart transplantation up until March 1990 at Kiel University Hospital. Forty of these could be investigated comprehensively. The neurological investigation comprised EEG and auditory and visually evoked potentials. The psychological investigation started with several neuropsychological tests; additionally all patients were interviewed and they completed questionnaires concerning anxiety, depression, ways of coping, personality characteristics and life satisfaction. Within the entire sample, there were few indications for specific psychological impairment. The psychosocial status of the patients was not significantly related to the time which had elapsed since they underwent transplantation. There were few associations between neuropsychological and psychosocial data, and several indicators of early postoperative complications which are described in the literature (e.g., length of stay in the intensive care unit). Clinically relevant subgroups (formed on the basis of neuropsychological test results, anxiety and depression) did not differ in terms of these indicators. Nevertheless, a considerable proportion of the patients (25%) were characterized by having a higher level of affective and neuropsychological impairment. Although based upon retrospective investigations, the results of this follow-up generally correlate with those gained from Anglo-American countries. In interpreting the results one needs to consider the possible influence of premorbid personality characteristics as well as denial which may be typical for patients undergoing heart transplantation.

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References

  1. Lesko L, Hawkins D. Psychological Aspects of Transplantation Medicine, New York: Aronson, 1983.

    Google Scholar 

  2. Castelnuovo-Tedesco P. Organ transplant, body image, psychosis. Psychoanal Quart 1973; 42: 349–363.

    Google Scholar 

  3. Watts D, Freeman AM, McGriffin DK et al. Psychiatric aspects of cardiac transplantation. Heart Transplant 1984; 3: 243–247.

    Google Scholar 

  4. Kuhn WF, Davis MH, Lippmann SB. Emotional adjustment to cardiac transplantation. Gen Hosp Psychiat 1988; 10: 108–113.

    Google Scholar 

  5. Kuhn WF, Brennan AF, Lacefield PK, et al. Psychiatric distress during stages of the heart transplant protocol J Heart Transplant 1990; 9: 25–29.

    Google Scholar 

  6. Evans RW, Maier AM. Outcome of patients referred for cardiac transplantation. J Am Coll Cardiol 1986; 8: 1312–1317.

    Google Scholar 

  7. Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol 1959; 32: 50–55.

    Google Scholar 

  8. Hamilton M. Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 1979; 6: 278–296.

    Google Scholar 

  9. Willner AE, Rodewald G. The Impact of Cardiac Surgery on the Quality of Life. New York: Plenum Press, 1990.

    Google Scholar 

  10. Beckmann D, Richter HE, Braehler E. Der Giessen-Test. Bern: Huber, 1983.

    Google Scholar 

  11. Spielberger CD, Gorsuch R, Luschene RE. State-Trait-Anxiety-inventory. Palo Alto: Consulting Psychologists Press, 1970.

    Google Scholar 

  12. Beck AT, Ward C, Mendelson M et al. An inventory for measuring depression. Arch Gen Psychiat 1961; 4: 561–571.

    Google Scholar 

  13. Fahrenberg J, Myrtek M, Wilk D, et al. Multimodale Erfassung der Lebenszufriedenheit: Eine Untersuchung an Herz-Kreislauf-Patienten. Psychother Med Psychol 1986; 36: 347–354.

    Google Scholar 

  14. Muthny FA. Freiburger Fragebogen zur Krankheitsverarbeitung. Weinheim, Beltz, 1989.

    Google Scholar 

  15. Lazarus RS. Ways of Coping Checklist. Berkeley, 1983 (unpublished).

  16. Mai FM, McKenzie FN, Kostuk WT. Psychosocial adjustment and quality of life following heart transplantation. Can J Psychiat 1990; 35: 223–237.

    Google Scholar 

  17. Jones BM, Chang VP, Esmore D, et al. Psychological adjustment after cardiac transplantation. Med J Austral 1988; 149: 118–122.

    Google Scholar 

  18. Strauss B, Strenge H, Graetz S, et al. Late postoperative status following coronary artery bypass surgery. Thorac Cardiovasc Surg 1992; 40: (in press).

  19. Everitt B. Cluster Analysis. Cambridge: Cambridge University Press, 1974.

    Google Scholar 

  20. Muthny FA. Zur Erkrankungsspezifitaet der Krankheitsverarbeitung. Zsch Psychosom Med 1988; 34: 259–273.

    Google Scholar 

  21. Lough M, Lindsey A, Shinn J, et al. Life satisfaction following heart transplantation. J Heart Transplant 1985; 4: 446–449.

    Google Scholar 

  22. Brennan AF, Davis MH, Buchholz DJ et al. Predictors of quality of life following cardiac transplantation. Psychosom 1987; 28: 566–571.

    Google Scholar 

  23. Porschke H, Strenge H, Stauch C. Neurological findings before and after heart transplantation. Unpublished manuscript.

  24. Kahan BD. Cyclosporine New Engl J Med 1989; 321: 1725–1738.

    Google Scholar 

  25. Meister ND, McAleer MJ, Meister JS, et al. Returning to work after heart transplantation. J Heart Transplant 1985; 5: 154–161.

    Google Scholar 

  26. Jones BM, Taylor FJ, Wright OM, et al. Quality of life after heart transplantation in patients assigned to double- or triple-drug therapy. Heart Transplant 1990; 9: 392–396.

    Google Scholar 

  27. Kraft IA, Vick J. The transplantation milieu, St. Luke's Episcopal hospital, 1968–1969. Sem Psychiat 1971; 3: 17–25.

    Google Scholar 

  28. Mai FM. Graft and donor denial in heart transplant recipients. Am J Psychiat 1986, 143: 1159–1161.

    Google Scholar 

  29. Young LD, Schweiger J, Beitzinger J, et al. Denial in heart transplant candidates. Psychother Psychosom 1991; 55: 141–144.

    Google Scholar 

  30. Speidel H. Heart surgery — a challenge for psychosomatic medicine. Paper presented at the European Conference on Psychosomatic Research, Helsinki, 1990.

  31. Herrick CM, Mealey PC, Tischner LL, et al. Combined heart failure transplant program: advantages in assessing medical compliance. J Heart Transplant 1987; 6: 141–146.

    Google Scholar 

  32. Frierson RL, Lippmann SB. Heart transplant candidates rejected on psychiatric indications. Psychosom 1987; 28: 347–355.

    Google Scholar 

  33. Freeman AM, Watts D, Karp R. Evaluation of cardiac transplant candidates. Psychosom 1984; 25: 197–207.

    Google Scholar 

  34. Freeman AM, Folks DG, Sokol RS, et al. Cardiac transplantation: clinical correlates of psychiatric outcome. Psychosom 1988; 29: 47–54.

    Google Scholar 

  35. Mai FM, McKenzie FN, Kostuk WJ. Psychiatric aspects of heart transplantation: preoperative evaluation and postoperative sequelae. Br Med J 1986; 292: 311–313.

    Google Scholar 

  36. Maricle RA, Hosenpud JD, Norman DJ, et al. Depression in patients being evaluated for heart transplantation. Gen Hosp Psychiat 1989; 11: 418–424.

    Google Scholar 

  37. Schall R, Petrucci R, Cavarocchi N, et al. The association of neuropsychological, demographic and medical variables with pre-and postoperative cognitive performance in candidates for and recipients of orthotopic heart transplantation In: AEWillner, ed. The Impact of Heart Surgery on Quality of Lifeabstracts. Glenn Oaks: Long Island Jewish Hospital, 1989: 50.

    Google Scholar 

  38. Bornstein R, Hammer D, Starling R, et al. Neuropsychological impairment in candidates for cardiac transplantation. In: AEWillner, ed. The Impact of Heart Surgery on Quality of Life-abstracts. Glenn Oaks. Long Island Jewish Hospital, 1989: 20.

    Google Scholar 

  39. Holson J, Pedley T. The neurological complications of cardiac transplantation. Brain 1976; 99: 673–694.

    Google Scholar 

  40. Kuensebeck HW, Wahlers T, Haverich A. Psychosoziale Situation und Lebenszufriedenheit bei herztransplantierten Patienten. In: HSpeidel, BStrauss, eds. Zukunftsaufgaben der psychosomatischen Medizin. Heidelberg: Springer, 1989: 331–336.

    Google Scholar 

  41. Walter PF. Quality of life after open-heart surgery. In: AEWillner, ed. The Impact of Heart Surgery on Quality of Life-Abstracts. Glenn Oaks: Long Island Jewish Hospital, 1989: 57.

    Google Scholar 

  42. McAleer M, Copeland J, Fuller J, et al. Psychological aspects of heart transplantation. Heart Transplant 1985; 4: 232–233.

    Google Scholar 

  43. Tabler JB, Frierson RL. Sexual concerns after heart transplantation, J Heart Transplant 1990; 9: 397–403.

    Google Scholar 

  44. O'Brien BJ, Buxton MJ, Ferguson BA. Measuring the effectiveness of heart transplant programmes. J Chron Dis 1987; 40: 137–153.

    Google Scholar 

  45. Niset G, Coustry-Degre C, Degre S. Psychosocial and physical rehabilitation after heart transplantation: 1-year follow up. Cardiol 1989; 75: 311–317.

    Google Scholar 

  46. Harvison A, Jones BM, McBride M, et al. Rehabilitation after heart transplantations: the Australian experience. J Heart Transplant 1988; 7: 337–341.

    Google Scholar 

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Strauss, B., Thormann, T., Strenge, H. et al. Psychosocial, neuropsychological and neurological status in a sample of heart transplant recipients. Qual Life Res 1, 119–128 (1992). https://doi.org/10.1007/BF00439719

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